Differentials and predictors of hospitalisation among the elderly people in India: evidence from 75th round of National Sample Survey (2017-2018)

In: Working with older people: community care policy & practice, Band 26, Heft 4, S. 325-341

Abstract

PurposeThere is limited evidence on the determinants of hospitalisation and its causes in India. This study aims to examine the differential in the hospitalisation rates and its socioeconomic determinants. This study also examines the causes of diseases in hospitalisation among the elderly (≥60 years) in India.Design/methodology/approachThis study used data from the 75th round of the National Sample Survey Organizations, collected from July 2017 to June 2018. The elderly samples in this survey are 42,759, where 11,070 were hospitalised, and 31,689 were not hospitalised in the past year or 365 days. This study estimated hospitalisation rates and carried out binary logistic regression analysis to examine the associations of hospitalisation with the background variables. The cause of diseases in hospitalisations was also calculated.FindingsThe hospitalisation rate was lower among elderly female compared to elderly male. Elderly who belongs to middle-old aged groups, non-married, North-Eastern region, Southern region, general caste, health insurance, partially and fully economically dependent have a higher chance of being hospitalised. About 38% elderly were hospitalised due to communicable diseases (CDs), 52% due to non-communicable diseases (NCDs) and 10% due to injuries and others (IO). Nearly 40% elderly were hospitalised in public hospitals due to CDs, whereas 52% were hospitalised in private hospitals due to NCDs and 11% due to IO.Research limitations/implicationsFirstly, this study is based on cross-sectional survey due to which temporal ambiguity averted to draw causal inferences. Secondly, other significant factors can also predict hospitalisations and provide insightful results, such as lifestyle factors, behavioral factors, obesity, mental state and several personal habits such as smoking cigarettes, drinking alcohol, consuming tobacco or other harmful substances. But this information was not available in this study. Even with these limitations, the hospitalisation issues among the elderly are beneficial to understand the current circumstances of CDs, NCDs and injury and other diseases for India and its states to formulate health policy.Practical implicationsEarly screening and early treatment for NCDs are needed, which are non-existent in almost all parts of India. It is essential to necessitate and identify the important factors that best predict hospitalisation or re-visit of hospital admission. Although, the medical advances in India have made rapid strides in the past few decades, it is burdened none the less, as the doctor–patient ratio is very low. It is important to develop preventive measures to minimize the accidents and causalities to avoid substantial cost associated with elderly health care.Social implicationsRaising awareness, promotion of healthy life style and improving the quality of good health-care provisions at primary level is a necessity.Originality/valueThe findings, practical and social implications provide a way forward for the health policymakers to potentially alter the future research to reduce associated comorbidities, unnecessary hospitalisations and other medical complications.